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Patient safety incident reports related to traditional Japanese Kampo medicines: medication errors and adverse drug events in a university hospital for a ten-year period.

Abstract Kampo medicine is traditional Japanese medicine, which originated in ancient traditional Chinese medicine, but was introduced and developed uniquely in Japan. Today, Kampo medicines are integrated into the Japanese national health care system. Incident reporting systems are currently being widely used to collect information about patient safety incidents that occur in hospitals. However, no investigations have been conducted regarding patient safety incident reports related to Kampo medicines. The aim of this study was to survey and analyse incident reports related to Kampo medicines in a Japanese university hospital to improve future patient safety.
PMID
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Authors

Mayor MeshTerms
Keywords

Adverse drug event

Drug-induced interstitial pneumonia

Kampo medicine

Medication error

Patient safety incident report

Scutellariae radix

Journal Title bmc complementary and alternative medicine
Publication Year Start




PMID- 29268743
OWN - NLM
STAT- In-Process
LR  - 20171222
IS  - 1472-6882 (Electronic)
IS  - 1472-6882 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Dec 21
TI  - Patient safety incident reports related to traditional Japanese Kampo medicines: 
      medication errors and adverse drug events in a university hospital for a ten-year
      period.
PG  - 547
LID - 10.1186/s12906-017-2051-2 [doi]
AB  - BACKGROUND: Kampo medicine is traditional Japanese medicine, which originated in 
      ancient traditional Chinese medicine, but was introduced and developed uniquely
      in Japan. Today, Kampo medicines are integrated into the Japanese national health
      care system. Incident reporting systems are currently being widely used to
      collect information about patient safety incidents that occur in hospitals.
      However, no investigations have been conducted regarding patient safety incident 
      reports related to Kampo medicines. The aim of this study was to survey and
      analyse incident reports related to Kampo medicines in a Japanese university
      hospital to improve future patient safety. METHODS: We selected incident reports 
      related to Kampo medicines filed in Toyama University Hospital from May 2007 to
      April 2017, and investigated them in terms of medication errors and adverse drug 
      events. RESULTS: Out of 21,324 total incident reports filed in the 10-year survey
      period, we discovered 108 Kampo medicine-related incident reports. However, five 
      cases were redundantly reported; thus, the number of actual incidents was 103. Of
      those, 99 incidents were classified as medication errors (77 administration
      errors, 15 dispensing errors, and 7 prescribing errors), and four were adverse
      drug events, namely Kampo medicine-induced interstitial pneumonia. The Kampo
      medicine (crude drug) that was thought to induce interstitial pneumonia in all
      four cases was Scutellariae Radix, which is consistent with past reports.
      According to the incident severity classification system recommended by the
      National University Hospital Council of Japan, of the 99 medication errors, 10
      incidents were classified as level 0 (an error occurred, but the patient was not 
      affected) and 89 incidents were level 1 (an error occurred that affected the
      patient, but did not cause harm). Of the four adverse drug events, two incidents 
      were classified as level 2 (patient was transiently harmed, but required no
      treatment), and two incidents were level 3b (patient was transiently harmed and
      required substantial treatment). CONCLUSIONS: There are many patient safety
      issues related to Kampo medicines. Patient safety awareness should be raised to
      prevent medication errors, especially administration errors, and adverse drug
      events in Kampo medicine.
FAU - Shimada, Yutaka
AU  - Shimada Y
AUID- ORCID: http://orcid.org/0000-0002-2836-0492
AD  - Department of Japanese Oriental Medicine, Graduate School of Medicine and
      Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194,
      Japan. [email protected]
FAU - Fujimoto, Makoto
AU  - Fujimoto M
AD  - Department of Japanese Oriental Medicine, Graduate School of Medicine and
      Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194,
      Japan.
FAU - Nogami, Tatsuya
AU  - Nogami T
AD  - Department of Japanese Oriental Medicine, Graduate School of Medicine and
      Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194,
      Japan.
FAU - Watari, Hidetoshi
AU  - Watari H
AD  - Department of Japanese Oriental Medicine, Graduate School of Medicine and
      Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194,
      Japan.
FAU - Kitahara, Hideyuki
AU  - Kitahara H
AD  - Department of Japanese Oriental Medicine, Graduate School of Medicine and
      Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194,
      Japan.
FAU - Misawa, Hiroki
AU  - Misawa H
AD  - Department of Japanese Oriental Medicine, Graduate School of Medicine and
      Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194,
      Japan.
FAU - Kimbara, Yoshiyuki
AU  - Kimbara Y
AD  - Department of Japanese Oriental Medicine, Graduate School of Medicine and
      Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194,
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20171221
PL  - England
TA  - BMC Complement Altern Med
JT  - BMC complementary and alternative medicine
JID - 101088661
OTO - NOTNLM
OT  - Adverse drug event
OT  - Drug-induced interstitial pneumonia
OT  - Kampo medicine
OT  - Medication error
OT  - Patient safety incident report
OT  - Scutellariae radix
EDAT- 2017/12/23 06:00
MHDA- 2017/12/23 06:00
CRDT- 2017/12/23 06:00
PHST- 2017/07/11 00:00 [received]
PHST- 2017/12/07 00:00 [accepted]
PHST- 2017/12/23 06:00 [entrez]
PHST- 2017/12/23 06:00 [pubmed]
PHST- 2017/12/23 06:00 [medline]
AID - 10.1186/s12906-017-2051-2 [doi]
AID - 10.1186/s12906-017-2051-2 [pii]
PST - epublish
SO  - BMC Complement Altern Med. 2017 Dec 21;17(1):547. doi: 10.1186/s12906-017-2051-2.